The circulating antibodies of the ABO blood groups may trigger a hyperacute reaction where a recipient receives a transfusion of blood from an incompatible donor. Circulating antibodies against antigenic determinants (epitopes), including those of the ABO blood groups (glycotopes), are also a major impediment to achieving successful transplantation. Removing anti-A/B antibodies by plasma exchange or plasmapheresis, splenectomy, and use of anti-B cell immunosuppressants are widely adopted strategies to avoid antibody dependant rejection of ABO-incompatible allografts.
Both the hyperacute reactions and delayed vascular rejections arising from ABO-incompatible transfusions and transplantations are triggered by the binding of anti-A/B antibodies to the A/B glycotopes expressed on the transfused red blood cells (RBCs) or vascular endothelial cells of the transplanted allografts. The binding of anti-A/B antibodies activates complement, platelet aggregation, and inflammation, resulting in intravascular haemolysis or thrombosis and occlusion of blood flow leading to the possible death of the recipient.
A need clearly exists for a method of neutralizing circulating antibody, at least transiently, to assist in the treatment or prevention of hyperacute reactions and delayed vascular rejections arising from ABO-incompatible transfusions and transplantations. It is to be anticipated that if such a need can be met, that similar methods may be employed to treat or mitigate hyperacute reactions and delayed vascular rejections arising from other glycotope-incompatible transfusions and transplantations.
It is an object of the invention to provide a method of neutralizing circulating antibody. It is an object of the invention to provide a method to be used in mitigating the risk of a clinically significant reaction to an incompatible blood transfusion. It is an object of the invention to provide a method to be used in mitigating the risk of rejection by a subject of an incompatible allograft or xenograft. It is an object of the invention to provide a method to be used in treating a subject with a clinically significant reaction to an incompatible blood transfusion. These objects are to be read disjunctively with the object of to at least provide a useful choice.